Individual provider Active NPI

Jocelyn Amber Gagnon, PT, DPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1568346252
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
214300 Issued in FL
Practice address
4593 S Dale Mabry Hwy
Suite 110
Tampa, FL 33611
Phone
(813) 250-1208
NPI assigned
Aug 5, 2025
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6009 NH
Physical Therapist 225100000X 214300 FL Primary

Addresses

Primary practice location

4593 S Dale Mabry Hwy
Suite 110
Tampa, FL 33611

Mailing address

645 1St Crown Point Rd
Strafford, NH 03884-6116
Phone (603) 833-9968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251031001655 FL Practitioner - Physical Therapist in Private Practice 6204325947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Rehabilitation, Inc.Group PAC ID 1355307398, 10 clinicians

Practice addresses (Care Compare)

4357 Lynx Paw TRL
Valrico, FL 33596-7426
Phone (813) 657-1208

4539 S Dale Mabry Hwy
Suite 110
Tampa, FL 33611-1404
Phone (813) 250-1208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
214300FLMDPhysical Therapist
6009NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation, Inc. CurrentSince Aug 25, 2025 Accepting new patients
Advanced Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

4539 S Dale Mabry Hwy
Ste 110
Tampa, FL 33611
Phone (813) 250-1208

4357 Lynx Paw Trl
Valrico, FL 33596
Phone (813) 250-1208

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1568346252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 1ST CROWN POINT RD",
            "city": "STRAFFORD",
            "state": "NH",
            "postal_code": "038846116",
            "telephone_number": "603-833-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4593 S DALE MABRY HWY",
            "address_2": "SUITE 110",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33611",
            "telephone_number": "813-250-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "JOCELYN",
        "middle_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "6009",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "214300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.